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重复经颅磁刺激在脑卒中康复中的研究热点与疗效

Research hotspots and effectiveness of repetitive transcranial magnetic stimulation in stroke rehabilitation.

作者信息

Xu Ai-Hua, Sun Yong-Xin

机构信息

Department of Rehabilitation Medicine, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.

出版信息

Neural Regen Res. 2020 Nov;15(11):2089-2097. doi: 10.4103/1673-5374.282269.

DOI:10.4103/1673-5374.282269
PMID:32394967
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7716019/
Abstract

Repetitive transcranial magnetic stimulation, as a relatively new type of rehabilitation treatment, is a painless and non-invasive method for altering brain excitability. Repetitive transcranial magnetic stimulation has been widely used in the neurorehabilitation of stroke patients. Here, we used CiteSpace software to visually analyze 315 studies concerning repetitive transcranial magnetic stimulation for stroke rehabilitation from 1999 to 2019, indexed by Web of Science, to clarify the research hotspots in different periods and characterize the gradual process of discovery in this field. We found that four main points were generally accepted: (1) repetitive transcranial magnetic stimulation has a positive effect on motor function recovery in patients with subcortical stroke; (2) it may be more advantageous for stroke patients to receive low-frequency repetitive transcranial magnetic stimulation in the unaffected hemispheres than to receive high-frequency repetitive transcranial magnetic stimulation in affected hemisphere; (3) low-frequency repetitive transcranial magnetic stimulation has become a potential therapeutic tool for patients with non-fluent aphasia after chronic stroke for neurological rehabilitation and language recovery; and (4) there are some limitations to these classic clinical studies, such as small sample size and low test efficiency. Our assessment indicates that prospective, multi-center, large-sample, randomized controlled clinical trials are still needed to further verify the effectiveness of various repetitive transcranial magnetic stimulation programs for the rehabilitation of stroke patients.

摘要

重复经颅磁刺激作为一种相对新型的康复治疗方法，是一种改变大脑兴奋性的无痛且非侵入性的方法。重复经颅磁刺激已广泛应用于中风患者的神经康复。在此，我们使用CiteSpace软件对1999年至2019年被科学引文索引收录的315项关于重复经颅磁刺激用于中风康复的研究进行可视化分析，以阐明不同时期的研究热点，并刻画该领域的逐步发现过程。我们发现四个主要观点已被普遍接受：（1）重复经颅磁刺激对皮质下中风患者的运动功能恢复有积极作用；（2）对于中风患者而言，在未受影响的半球接受低频重复经颅磁刺激可能比在受影响的半球接受高频重复经颅磁刺激更具优势；（3）低频重复经颅磁刺激已成为慢性中风后非流畅性失语患者进行神经康复和语言恢复的一种潜在治疗工具；（4）这些经典临床研究存在一些局限性，如样本量小和测试效率低。我们的评估表明，仍需要进行前瞻性、多中心、大样本、随机对照临床试验，以进一步验证各种重复经颅磁刺激方案对中风患者康复的有效性。

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